Term
| In 1952, Hildegard Peplau defined psychiatric nurse’s role as: |
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Definition
| a resource person, teacher, a leader, and a COUNSELOR to patient |
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Term
| Peplau’s classic article “interpersonal techniques and the crux of psychiatric nursing”… directed psychiatric nursing and future growth by: |
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Definition
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Term
| The contribution during the 1880’s of Linda Richards, the first American psychiatric nurse, that remains a part of contemporary psychiatric nursing practice is the idea that: |
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Definition
| nurses should assess both physical and emotional needs of patients |
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Term
| A nurse states, “I plan ways for patients assigned to me to participate in their own care to and to be actively involved in all the activities on the unit”; this approach demonstrates the concept of |
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Definition
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Term
| During the orientation portion of a psychiatric nurse course, which would the instructor be mostly likely to tell students |
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Definition
| psychiatric nursing patient may be an individual, family, a group, organization or community |
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Term
| The movie “The Snake Pit” was a seminal event because the subject to the mental illness was |
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Definition
| a taboo subject with the just the phrase “nervous breakdown” articulated |
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Term
| Shock treatment was utilized in the movie “The Snake Pit” in order to |
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Definition
| help the patient be more amenable to psychotherapy |
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Term
| Today, during orientation to the inpatient psychiatric unit, new staff members are told to “address all patients by their title and surname, for ex, Ms. Jones or Mr. Rodriguez, until you are directed by the patient to do otherwise. The philosophical belief underlying this idea is |
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Definition
| individual has worth and dignity |
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Term
| The role of a psychiatric nurse in today’s contemporary practice setting is |
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Definition
| centered on the nurse-patient relationship |
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Term
| Clinical rotations for nursing students include a psych mental health rotation to give the student an opportunity to |
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Definition
| learn to interact with patients with various psych mental health issues, because communication is the foundation of nursing |
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Term
| Almost every interviewing model has an orientation or introductory phase. The intention is to develop communication that fosters a working relationship. All of the following are included in orientation: |
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Definition
a. To explore patient’s perceptions, thoughts, feelings and actions by being patient
centered.
b. To identify pertinent patient problems, which often patients are able to
articulate on admission. Often times, a new admission will give more info than
at any other time.
c. To define mutual, specific goals with the patient, which often are the result of
the multi-disciplinary team’s input. |
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Term
| Stuart (2009) suggests that 55% of nonverbal communication is transmitted by body cues. Nonverbal behaviors include: |
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Definition
| voice inflections, facial expressions, posture, body positioning, energy levels and gestures. |
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Term
| It is OK to ask a patient what he is experiencing rather than trying to interpret what a person is conveying. It is difficult to know if a frown is a headache, worry, pain, voices, etc. However, if a patient admits to hearing voices, and you see him responding to them, should this must be noted? |
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Definition
| Yes, ie. Patient appears to be responding to voices, standing alone in room shouting, “Let me alone. Stop saying I’m a bad person.” |
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Term
| Therapeutic relations are different from social relationships because: |
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Definition
| the focus is on the client. The other difference is the type of responsibility that a nurse has for the patient. |
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Term
| The Communication Process is one of the models which incorporate perceptions, evaluation and transmission. The setting in which this communication takes place is: |
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Definition
| Sender, Message, Receiver, Feedback, Context |
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Term
| In 1964, Eric Berne wrote a book still quoted today called Games People Play. Berne developed a model which he named the Transactional Analysis Model. This theory relates to ego states that closely parallel Freud but which make it easier for lay people to understand. How is personality organized? |
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Definition
| The personality is organized into the three ego states of parent, child, and adult. |
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Term
| Students are encouraged to listen to their patients, either actively or passively. This means being in the present, with complete attention on the patient. |
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Definition
| The student should not be preoccupied with school, family issues, or personal problems. Most importantly, the student shouldn’t share his/her own problems, experiences or issues with the patients. Saying, “I had a similar problem and this is how I handled it,” is tempting but unacceptable. |
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Term
| One of the greatest barriers to therapeutic communication is: |
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Definition
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Term
| The therapeutic milieu or community was originally created for long-term patients. This refers to: |
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Definition
| self-governance, meetings to plan activities and special food, etc. However, the average stay of patients can be short because of limited insurance payments. The expectation of self-care and participation, therefore, may be inappropriate for a person in crisis or for a person who is private and limits interaction when not manifesting signs of mental illness. |
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Term
| A patient says to a nurse, “Why should I talk to you? Everybody knows talking doesn’t help!” The nurse’s best response is: |
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Definition
| usually never started with “why.” “Why do you think that talking won’t help?” sorta is like saying to Johnny, “Why did you drop your ice cream cone?” “Why” often sounds confrontational. Telling the patient that you are there to talk about his concerns is the best choice given. |
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Term
| What do you do if a patient is rushing toward you? |
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Definition
| do not turn and run! This expression of fear for a patient out of control who is usually scared him/herself will escalate the situation. Putting your arms out straight with fingers spread outward like police do when stopping traffic and saying in an authoritative voice “Stop” is probably the best initial reaction. And it has been known to work for rushing patients and Alzheimer patients as well. |
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Term
| Depersonalization is characterized by feelings of: |
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Definition
| detachment, isolation, alienation, unreality, confusion and a dreamlike view of the world. A patient who expresses feelings of detachment, isolation and totally noninvolvement with activities around him suffers from depersonalization. He/she may express feeling of not being awake or asleep and have confusion about being dead or alive. |
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Term
| Therapeutic acceptance – Acceptance involves giving support without making demands. Simply sitting with a patient who is extremely psychotic and withdrawn shows acceptance, support and caring. If a patient feels like a robot and expresses a lack of feelings, an attempt at establishing a verbal relationship would probably not be effective. |
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Definition
| In psychosis, there is an extreme loss of contact with reality, often accompanied by delusions, hallucinations, bizarre behaviors and/or disorganized speech patterns. Patients often feel frightened. Sitting with a patient makes them feel less alone. |
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Term
| A patient with a self-concept disturbance initially would benefit from an empathetic type of communication. “Empathy is the ability to enter into the life of another person to accurately perceive the person’s current feelings and their meanings, and to communicate this understanding to the patient (Stuart, Page 33) . Empathy is an essential part of the therapeutic process. How does a nurse’s use of sympathetic communication sometimes hinder a patient’s work in developing a more realistic self-concept? |
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Definition
| Sympathy reinforces self-pity and self-pity stands in the way of the patient’s realizing that the power to change lies within himself or herself, which is the desired outcome of patient self-exploration. |
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Term
| A patient most likely exhibiting a somatization disorder is the college graduate who cannot maintain steady employment because of multiple vague complaints. Patients with a somatization disorder are: |
|
Definition
| usually younger than 30 years who have unexplained symptoms with no known medical basis. They get a secondary gain, skip work or get disability. Sometimes it gratifies a dependency need or a relief from an unpleasant situation and/or may reduce patient’s anxiety. |
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Term
| A conversion reaction is a type of somatoform disorder in which symptoms of some physical illness appear without any underlying organic cause. The organic symptom reduces the patient’s anxiety and usually gives a clue to the conflict. During wars, this is seen more often, with people losing their sight or ability to use an arm or leg. If a night guard goes blind suddenly, he may be: |
|
Definition
| having a conversion reaction. If there is an attempt too soon to fix the problem with therapy or hypnosis, the person may unconsciously let go of one affliction for another i.e. may have walking restored but becomes blind. |
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Term
| The expected outcome of therapy for a patient with a somatoform disorder would be: |
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Definition
| that a patient could express feelings verbally rather than through the development of physical symptoms. Because the patient with a somatoform disorder is using physical symptoms to express feelings, the goal of verbalizing feelings is appropriate. |
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Term
| Which intervention should a nurse select to help a patient cope more effectively with a chronic pain disorder? |
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Definition
| The therapy selected will be one that can be used over the long term. Relaxation training, which helps the patient control tension and anxiety and thereby reduce pain, can be an effective long-term strategy. Benzodiazepines and opioids are both habit forming and they are not useful for the long term. Response prevention rarely is used to treat chronic pain. |
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Term
| Which patient would be at greatest risk of encountering the exhaustion phase of the general adaptation syndrome? |
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Definition
| The exhaustion phase of the general adaptation syndrome often is associated with lose. A patient with severe osteoarthritis who has lost a caretaker spouse and a home to live in a nursing home would be the most stressed. Knee surgery, a job promotion and rhinoplasty to correct a prominent hump in the nose shouldn’t cause exhaustion from stress. |
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Term
| Which patient would be at greatest risk of encountering the exhaustion phase of the general adaptation syndrome? |
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Definition
| The exhaustion phase of the general adaptation syndrome often is associated with lose. A patient with severe osteoarthritis who has lost a caretaker spouse and a home to live in a nursing home would be the most stressed. Knee surgery, a job promotion and rhinoplasty to correct a prominent hump in the nose shouldn’t cause exhaustion from stress. |
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Term
| A patient who had two rhinoplasy but continues to seek surgery even though he was told he doesn’t need it and feels his life will be ruined unless he has surgery probably has a: |
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Definition
| body dysmorphic disorder. A body dysmorphic disorder is a pre-occupation with an imagined defect in appearance. |
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Term
| If a nurse is working with a patient who is expressing psychophysiological symptoms, it is important that the nurse understands that: |
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Definition
| the patient’s symptoms are serious and possibly fatal if untreated. Psychophysiological disorders have stress-related physical symptoms associated with organic pathology. Treatment of symptoms and mitigation of psychological factors are indicated. |
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Term
| A patient diagnosed with body dysmorophic disorder continues to be dissatisfied with the appearance of her nose, claiming it will prevent her from ever finding happiness. A possible nursing diagnosis to consider for this patient is: |
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Definition
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Term
| Occasionally a patient will lose a spouse and still talk about them as though they are still living. Despite this, they may articulate an inability to go on alone and talk about a plan to take sleeping pills. This inability to cry or express emotions and speaking of the deceased in the present tense suggest the use of: |
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Definition
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Term
| If a mother loses a child in an automobile accident and is still crying herself to sleep every night after a month, this may distress her husband. If the husband asks what he should do, the nurse could tell him that: |
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Definition
| while it is distressing to see his wife so upset, crying is a way for the wife to express her feelings. This reply is empathetic and allows the nurse to begin teaching the spouse the value of expressing feelings related to loss. |
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Term
| A patient who says that every fall and winter his mood becomes low, feels tired, gains weight, and eats lots of sweets is probably suffering from: |
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Definition
| seasonal affective disorder. It is associated with shortened hours of daylight and abnormal melatonin metabolism |
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Term
| Manic states are characterized by expansive, abnormally elevated or irritable moods, impaired social or occupational functioning, increased motor activity, decreased sleep, grandiosity and rapid, pressured speech. The patient may write worthless checks, make bad business deals and behave in a very sexual manner. A DSM-IV-TR diagnosis would be: |
|
Definition
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Term
| For depression with suicidal ideation with no plan, sertraline (Zoloft) is often prescribed. After getting medication, the patient may report that feelings of depression have lessen. It is important for the nurse to remember that patients very depressed and suicidal may: |
|
Definition
| not have the energy to implement a plan. As depression lifts, the patient may be better able to plan a suicide attempt and may have sufficient energy to carry out a plan. Vigilance continues to be necessary. |
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Term
| When a patient is prescribed Prozoc, nurses should make patients aware that: |
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Definition
| antidepressant medications work slowly, requiring 2 to 6 weeks for amelioration of symptoms. Patients without this knowledge may discontinue taking the medication, thinking it is not working. |
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Term
| Sometimes nursing students think that while manic patients tire them out at least they don’t have to worry about them dying. A good response from the instructor would be: |
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Definition
| to consider they ways that acute manic states can also be life threatening. These patients show poor judgment, excessive risk taking, and an inability to evaluate realistic danger and the consequences of their actions. Extreme hyperactivity can lead to exhaustion and death. |
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Term
| When a patient has severe depression, somatic delusions and suicidal ideation and doesn’t respond to SSRI (selective serotonin reuptake inhibitor) medication and tricyclic antidepressants, |
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Definition
| electroconvulsive therapy remains a viable treatment. |
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Term
| The term hypomania refers to: |
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Definition
| a state just below mania. The same psychomotor activities and other symptoms similar to mania exist but are less pronounced. |
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Term
| Patients often ask if they can discontinue lithium if they are feeling better. The nurse needs to reinforce that: |
|
Definition
| taking medication daily will help him/her avoid relapses and reoccurrences. Patients with bipolar disorder are maintained on medication indefinitely to prevent reoccurrences. The earlier and more thoroughly the patient understands this need, the more likely it is that he or she will comply with the long-term treatment plan. |
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Term
| If a family member asks you if schizophrenia is considered to have neurobiological origins, what part of the brain is dysfunctional? You can safely say that research implicated: |
|
Definition
the prefrontal and limbic cortices.
Note: The two most consistent neurobiological research findings in schizophrenia are imaging studies that show reduced brain volume and abnormal function, and neurochemical studies that show alterations of neurotransmitter systems affecting the prefrontal cortex and the limbic system. |
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Term
| Patients may be delusional and anxious but may not be ready to give up the delusions. After two days, the nurse can help the patient focus less on the delusion by: |
|
Definition
planning activities that require physical skills and constructive use of time.
Note: Engaging the patient in physical activity will help distract the patient and keep the patient from focusing solely on the delusion. The patient would still be able to focus on the delusion while appearing to be reading or listening to music. While nurses focus on discharge almost when a patient is admitted in order to establish goals, often patients are too ill to be included. |
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Term
| When teaching patients and families about relapse include: |
|
Definition
Caffeine and nicotine can reduce the effectiveness of antipsychotic and antianxiety drugs.
Note: Caffeine intake greater than 250 mg. daily (one cup) or smoking 10 to 20 cigarettes daily can dramatically reduce the effectiveness of antipsychotic and antianxiety drugs and lithium. The need to limit the use of these substances is an important teaching point. |
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Term
| An appropriate short-term goal for a withdrawn, isolated patient diagnosed with schizophrenia is: |
|
Definition
the patient will consistently interact with an assigned nurse.
Note: Interacting with at least one person is desirable to reduce complete withdrawal and isolation. Such interaction provides the basis for formation of trust and the development of a nurse-patient relationship. |
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Term
| The nursing diagnosis most likely to be used for a person who has a diagnosis of paranoid schizophrenia: |
|
Definition
Social isolation related to impaired ability to trust.
Note: Individuals with paranoid schizophrenia are usually distrustful of others and socially withdrawn. They often have delusions of persecution and auditory hallucinations that further serve to isolate them from others. |
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Term
| The medical records of a patient diagnosed with schizophrenia state that the patient has cognitive dysfunction. From this statement, the nurse can expect to see evidence of: |
|
Definition
Impaired memory and attention as well as formal thought disorder.
Note: Problems in cognitive functioning include impaired short-term and long-term memory, poor concentration, distractibility, loose associations, tangentially (thoughts stray, never return to central point or answers original question), incoherence, illogical speech or concrete thinking, indecisiveness, impaired judgment and delusions, just to mention a few!! |
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Term
| A patient with schizophrenia repeatedly asks for directions and the time of day. The nurse should: |
|
Definition
repeat the information in a kind, matter-of-fact manner.
Note: The person with schizophrenia has brain malfunction resulting in poor memory and attention. The information should be repeated as often as necessary in a kind, patient manner. |
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Term
| If a patient thinks his brain is tapped and a device is planted in his head, after one week a nurse can have as a goal: |
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Definition
Interpreting reality correctly by stating no “brain tap” has been implanted.
Note: An appropriate outcome for a delusional patient is that the patient will interpret reality correctly. |
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Term
| A patient diagnosed with schizophrenia reveals to the nurse that voices have warned of danger and asks if the nurse hears them. The nurse’s best response would be: |
|
Definition
to say that although she recognizes that the voices are real to a patient, she doesn’t hear them.
Note: The nurse shouldn’t kid the patient along but accept the reality of the hallucinations for the patient. Interactive discussion of hallucinations is a vital element in the development of reality-testing skills. |
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Term
| If a nurse observes a patient who is sitting alone in a room with both hands over both ears and shaking her head, the patient may be: |
|
Definition
experiencing auditory hallucinations.
Note: Impulsive activity, talking to people who are not present, and covering the ears are behaviors that may indicate the patient is responding to auditory hallucinations. |
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Term
| A nursing diagnosis that has wide application for patients who use mood-altering drugs can be: |
|
Definition
| ineffective coping, disturbed sensory perception, disturbed thought processes and disturbed family processes. |
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Term
| Abstinence and relapse is best viewed as a process rather than an outcome. It is often not "all or nothing", but improvements. If a nurse views relapse as an error from which to learn and a temporary setback to recovery, the patient has a better chance of |
|
Definition
| recommitting to the treatment plan. |
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Term
| Cognitive behavioral approaches are aimed at improving self-control and social skills to reduce substance use. Self-control strategies include: |
|
Definition
| goal setting, self-monitoring, analysis of drinking or drug antecedents and learning of alternative coping skills. Learning skills for socialization include forming and maintaining interpersonal relationships, assertiveness and drink or drug refusal. |
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Term
| If a patient has a blood alcohol level (BAL) of 4.0 and is still walking and conscious although acting inebriated, he has a high tolerance to alcohol. A non-tolerant individual would be comatose. As he withdraws from alcohol, he may: |
|
Definition
| have tremors, anxiety, visual hallucinations, insomnia, and disorientation accompanied by vomiting, temp elevation, tachycardia and diaphoreses. This is known as alcohol withdrawal delirium. The onset usually is 3 - 5 days after the last drink and lasts 2- 3 days. It is considered a medical emergency. The highest priority for a nurse is the maintenance of fluid and electrolyte balance. |
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Term
| Withdrawal from alcohol, barbiturates and benzodiazepines is similar. The goal is: |
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Definition
| to prevent severe withdrawal symptoms by giving a drug with a similar action that is tapered down and eventually discontinued. |
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Term
| A nurse should keep in mind the fatal story told by our speaker, Linda Reynolds, about a doctor who ordered medication every hour for 5 hours, forgetting about the half life of the medication. This story tells us that: |
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Definition
| The longer the half-life of the drug, the longer the withdrawal symptoms will last and the less intense the withdrawal symptoms will be. |
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Term
| Nurses who embrace the holistic approach to psychiatric nursing would look at: |
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Definition
| physical exercise and meditation as a daily component of the addiction treatment for a patient. The reason is that there is a release of endorphins that occurs with strenuous exercise and mediation and results in a feeling of well-being and reduced cravings. |
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Term
| It is imperative that a nurse know if a person has a history of alcohol abuse before surgery. Otherwise, excessive use of alcohol may result in the patient experiencing withdrawal symptoms or other alcohol-related problems postoperatively. Screening tests increase the accuracy of assessment. One of the best is the CAGE Questionnaire which includes: |
|
Definition
a. Have you ever felt that you should Cut down on you drinking?
b. Have people Annoyed you by criticizing your drinking?
c. Have you ever felt bad or Guilty about your drinking?
d. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener) |
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Term
| PCP consumers often are extremely aggressive and in an acutely psychotic state in which the patient is markedly agitated and violent. Violence toward self or others is common. Because the drug produces anesthesia, the patient may be unaware of pain. If the prescribed dose of benzodiazepine can't be given because of patient's aggressive behavior, the safety of the patient and others is an important concern. The patient should be: |
|
Definition
| taken to the seclusion room because it provides an environment of minimal stimulation, essential to calming the patient. Then the patient should be given benzodiazepine as quickly as possible. |
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Term
| If a patient overdoses on Heroin, the drug that can save his/her life is: |
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Definition
| Naltrexone. It is an opoioid receptor antagonist that goes under the name Revia or Depade |
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Term
| When a patient with chronic depression and his parents are discussing ECT with the nurse, what is the best example of therapeutic communication? T |
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Definition
| he best way to start is not talking “at” them and giving lots of information. You can’t go wrong in asking a person “What do you know about ECT treatment?” Sometimes their fear is so great that they can’t hear what you are teaching or have so little information that they don’t even know what questions to ask. |
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Term
| Patients worry about missing breakfast and may ask you about eating. What they may really be asking is: |
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Definition
| if they will survive the procedure. Assuring a patient that they will get breakfast when they get back to the unit is comforting and reassuring. Unless a medication is really needed, none is given for fear of water and pill aspiration during the ECT procedure. |
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Term
| A nursing intervention that is important for ECT patients is: |
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Definition
| to have the patient void before walking or wheeling him/her to ECT to spare incontinence embarrassment. |
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Term
| Assisting with “preprocedure care” of a patient scheduled for ECT, refers to the care immediately before the procedure. A patient would not be scheduled without an informed consent form, usually signed one day with the procedure given the next day. Electrode site preparation and ECG equipment is generally handled by the ECT team. As an assisting nurse, your task may be: |
|
Definition
| application of the oxygen saturation probe to the finger and application of a blood pressure cuff. Your book is confusing in discussing “Preprocedure care. |
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Term
| When receiving bilateral ECT, generalized seizures are monitored in the cuffed foot and by EEG changes. How long should ECT seizures last? |
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Definition
| They last only 15 – 20 sec. Seizures lasting more than 2 min. must be terminated. |
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Term
|
Definition
| patients with major depression who are stuporous or lethargic. |
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Term
| Orient the patient post ECT periodically by telling him: |
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Definition
| where he is, assess orientation times 3 (time, place and person) and emphasize that memory loss is temporary. Frequently in psych it is charted, “Oriented X 3”. |
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Term
| If a patient is concerned about ECT being barbaric and dangerous, a nurse could say: |
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Definition
| that she understands his/her concerns but research has proven that this therapy has the same risk as minor surgery and actually presents a lower risk than medication. (I generally tell students not to say “research proves” but if that is your test option…) |
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Term
| Can depressed patients be cured of depression through sleep deprivation? |
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Definition
| False. While 60% of depressed people are helped by “Sleep Deprivation Therapy”, the depression returns soon after patients return to normal sleeping. |
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Term
| If a patient asks you about participating in a TMS research trial, you may tell him/her that: |
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Definition
| while it does help depression, it isn’t safe for a person with an implanted pacemaker. |
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Term
| When writing long term goals or expected outcomes with a patient diagnosed with anorexia nervosa, consider how a patient will cope after discharge. Ultimately: |
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Definition
| you want the patient’s healthy eating patterns restored and their weight and nutrition to have normal parameters. |
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Term
| Perhaps the most frequently used coping mechanisms for patients with anorexia nervosa is: |
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Definition
| Denial about the appropriateness of body weight and their nutritional intake, their insistence of normalcy, and their need for help. |
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Term
| For a patient with anorexia nervosa, the major issue is: |
|
Definition
| about control of the person’s life and fears. Whether the fear is of maturity, independence, failure, sexuality or parental demands, patients with anorexia nervosa believe the solution to the problem lies in controlling their food intake and their bodies. With increasing family concern, patients with anorexia nervosa also control the focus of significant others. |
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Term
| Assessment of anorexia nervosa includes: |
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Definition
| Weight, temp, BP, TPR, menses, and verbal history. If a person has a low weight of 30% of body weight, is cold, has poor skin turgor, lanugo (downy hair covering body), and admits to a low oral intake, he/she may be diagnosed as anorexia nervosa. |
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Term
| A short-term goal for a patient with anorexia nervosa is: |
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Definition
| that patient will select and eat a balanced diet. The intervention most appropriate is to assist the patient to fill out the dietary menus to give a sense of control for patient yet ensure a balanced diet. |
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Term
| When a patient with anorexia nervosa is admitted, the first goal is that: |
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Definition
| the patient is able to eat 100% of each meal served. Only then may the patient assume some control over scheduling of meals and food selection. |
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Term
| The rationale for establishing a contract with a patient with an eating disorder at the outset of treatment is: |
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Definition
| that a contract helps engage the patient in the therapeutic alliance and obtains commitment to the treatment process. |
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Term
| Patients often say that if they binge, their feelings of both isolation and loneliness go away. This is: |
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Definition
| a cognitive distortion or a personal belief that lacks logic and is not reflective of reality. |
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Term
| A person with bulimia typically is: |
|
Definition
| of average weight or is slightly overweight and has a history of unsuccessful dieting. |
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Term
| Co-morbid major depression or dysthymia has been reported in 50% to 75% of people with anorexia and bulimia. An obsessive-compulsive disorder may be found in as many as 25% of patients with anorexia nervosa. Anxiety disorders and substance abuse also occur, but their incidence is lower than depression. Individuals who have binge-eating disorder, not anorexia nervosa, are: |
|
Definition
| more likely to have a personality disorder. Schizophrenia is not reported to be associated with anorexia nervosa. |
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Term
| Antisocial personality disorders are exploitative and manipulative. They prefer to control others to avoid being controlled. The attitudes of “live and let live” and “help one another” are not reflective of an individual with antisocial personality disorder. They would prefer to take advantage of others. Antisocial personality disorder patients are: |
|
Definition
| personable and persuasive, often able to convivce others of their good intentions. They are seldom able to maintain the good intentions they profess and revert to antisocial behaviors. |
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Term
| Therapeutic strategies for patients with borderline personality disorder have to be designed for the expected behaviors from a borderline. These behaviors are often clinging, acting out, mood shifts and impulsivity. Features of the borderline also include: |
|
Definition
| Instability, hypersensitivity, self-destructive behavior, and unstable and intense interpersonal relationships. |
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Term
| Behavior that is most characteristic of an individual with narcissistic personality disorder is: |
|
Definition
| entitlement to special privileges that others may not have. Narcissistic individuals are egocentric people who have fragile self-esteem that drives them to seek admiration, appreciation and special treatment. |
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Term
| One of the aspects of a borderline personality disorder is the inability to integrate the good and bad aspects of an object. They see others as either perfect or the worst person in the world. This is one definition of: |
|
Definition
|
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Term
| Antisocial personality disorder patients often split the team with some nurses maintaining that the patient is really pleasant while others believe that external limits and careful observation are necessary. Another interactional situation occurs when the patient projects certain aspects of the self onto another. If this projection is positive, then a nurse likes the patient and has a tendency to lose objectivity. The nurse then moves toward over involvement, overprotection, and indulgence. This negative or positive practice of projection from a patient is known as: |
|
Definition
| projective identification. |
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Term
| Maladaptive social behaviors of manipulation need to be addressed by the staff. The staff always must: |
|
Definition
| seek to convey acceptance of the patient because this is a building bock for a therapeutic relationship. Inappropriate behaviors such as manipulation should be identified, their negative consequences to the patient should be discussed and more adaptive behaviors should be substituted when the therapeutic relationship has been established. |
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Term
| The three features of personality disorders are: |
|
Definition
(1) the individual has acquired few strategies for relating and his or her approaches are inflexible and maladaptive;
(2) the individual’s needs, perceptions and behavior tend to foster vicious circles that continue unhelpful patterns and provoke negative reactions from others.
(3) the individual’s adaptation is characterized by tenuous stability, fragility, and lack of resilience when faced with stress. The patient’s treatment plan is directed toward improvement of patient condition, but it does not guarantee improvement or a cure. The family should not expect a huge change in behavior. |
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Term
| If a patient is described as being “lively, excessively emotional, attention seeking, and superficial” and has a history of stormy relationships with friends and lovers, wanting always to be the focus of attention, then the diagnosis is: |
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Definition
| usually histrionic personality disorder, a cluster B disorder that includes seductiveness, being unsympathetic and being manipulative. |
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Term
| The care plan for a patient with a personality disorder contains the following interventions: |
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Definition
| Demonstrate accessibility, maintain confidentiality and maintain consistent behavior by all nursing staff. The establishment of a therapeutic nurse-patient relationship is fundamental to successful treatment. The interventions listed will foster an atmosphere of trust and open expression of thoughts and feelings, yet not allow the patient to use manipulation as a way of relating to staff and family. |
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Term
| Impaired social interaction describes a state in which the person participates in insufficient , excessive, or ineffective social exchange. Impaired social interaction is the nursing diagnosis that: |
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Definition
| pertains to the antisocial personality disorder patient. |
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Term
| Whenever there is a concern for suicide, the patient should be assessed immediately for suicide ideations as well as plan. Higher risks include: |
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Definition
| When there is a history of a suicide attempt and if the patient is a white male over 65 years of age. |
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Term
| Depression, grief, and loss are common in later life. Assessment of the patient's reaction to the loss and the ability to grieve appropriately is the most therapeutic initial nursing intervention. Assess for past coping skills. Check for support systems. If mourning and grief are prolonged, they should be: |
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Definition
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Term
| Paranoia, a classic organized and complicated delusional system that is rare in older adults, can be caused by sensory deprivation or loss, medications, social isolation, delirium, and dementia. The older adult with a paranoid personality will: |
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Definition
| exhibit withdrawal, aloofuess, fearfulness, oversensitivity, or secretiveness. He/she may feel safe only if the same staff person cares for him. |
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Term
| People who are busy and people who have depression can experience short-term memory loss since both states are more likely to result in a shorter attention span and lack of mental focus. This is frightening to an older person. What can a nurse do in this instance? |
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Definition
| Listen to their concerns and reassure this is normal for very busy or depressed people. |
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Term
| When a patient's only child moves 300 miles away, a nurse must: |
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Definition
| make a comprehensive assessment of the patient's local family and social support systems. |
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Term
| The psychological theory of aging states that an individual's personality is established by adulthood and remains stable, although adaptable, over time. Any major change may indicate: |
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Definition
| physiological disease (e.g., brain disease). If a person is generally cheerful and there is a change, it is best to start looking first at possible physical causes. |
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Term
| Older patients benefit from an environment that is: |
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Definition
| Interesting and appropriate activities, a sense of calm and quiet (soft colors, soothing music, use of personal articles), a consistent physical layout with no environmental barriers, and a structured daily routine. Older people, even when not ill, usually don't like change. |
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Term
| When you see a patient crying, the most appropriate statement is: |
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Definition
| the one that attempts to use therapeutic communication to determine whether the patient is depressed. Try to elicit more information about the patient's feelings. This would be the most effective means of assessing the patient's emotional status. |
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Term
| The "best interests standard" is applied when the patient lacks decisional capacity and no other designated health care proxy are available. This standard is: |
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Definition
| based on what would promote the welfare of the "average" patient. |
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Term
| Studies have shown that when pain and depression are adequately treated, patient requests to hasten death diminish. Therefore: |
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Definition
| treat pain and depression quickly. |
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